MRS. LAYLA MYERS MABE ANP
Complete NPI Record 1790774628
Nurse Practitioner in Pinehurst, NC

NPI Status: Active since October 13, 2005

Contact Information

15 REGIONAL DR
PINEHURST, NC
ZIP 28374
Phone: (910) 255-4400
Fax: (910) 235-3447

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  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider First Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider Business Mailing Address Fax Number
  15. Provider First Line Business Practice Location Address
  16. Provider Business Practice Location Address City Name
  17. Provider Business Practice Location Address State Name
  18. Provider Business Practice Location Address Postal Code
  19. Provider Business Practice Location Address Country Code If outside U S
  20. Provider Business Practice Location Address Telephone Number
  21. Provider Business Practice Location Address Fax Number
  22. Provider Enumeration Date
  23. Last Update Date
  24. Provider Gender Code
  25. Healthcare Provider Taxonomy Code 1
  26. Provider License Number 1
  27. Provider License Number State Code 1
  28. Healthcare Provider Primary Taxonomy Switch 1
  29. Healthcare Provider Taxonomy Code 2
  30. Provider License Number 2
  31. Provider License Number State Code 2
  32. Healthcare Provider Primary Taxonomy Switch 2
  33. Other Provider Identifier 1
  34. Other Provider Identifier Type Code 1
  35. Other Provider Identifier State 1
  36. Other Provider Identifier Issuer 1
  37. Other Provider Identifier 2
  38. Other Provider Identifier Type Code 2
  39. Other Provider Identifier State 2
  40. Other Provider Identifier Issuer 2
  41. Other Provider Identifier 3
  42. Other Provider Identifier Type Code 3
  43. Other Provider Identifier State 3
  44. Other Provider Identifier 4
  45. Other Provider Identifier Type Code 4
  46. Other Provider Identifier State 4
  47. Other Provider Identifier Issuer 4
  48. Other Provider Identifier 5
  49. Other Provider Identifier Type Code 5
  50. Other Provider Identifier State 5
  51. Other Provider Identifier 6
  52. Other Provider Identifier Type Code 6
  53. Other Provider Identifier State 6
  54. Other Provider Identifier Issuer 6
  55. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1790774628. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1790774628
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: LAYLA
The first name of the provider, if the provider is an individual.
Provider Middle Name: MYERS
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MRS.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: ANP
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 205 PAGE RD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: PINEHURST
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NC
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 283748749
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9102955511
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 9102353447
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 15 REGIONAL DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: PINEHURST
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NC
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 283748850
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9102554400
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9102353447
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/13/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 2/25/2014
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 363L00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 900378
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: NC
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Healthcare Provider Taxonomy Code 2: 363LA2200X
Provider License Number 2: 900378
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: NC
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Other Provider Identifier 1: P00439348
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: NC
Other Provider Identifier Issuer 1: RR MEDICARE
Other Provider Identifier 2: 89014R7
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: NC
Other Provider Identifier Issuer 2: CAROLINA ACCESS
Other Provider Identifier 3: NP0937
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: SC
Other Provider Identifier 4: P01173872
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: NC
Other Provider Identifier Issuer 4: R/R MEDICARE EFFECTIVE 2/25/2013
Other Provider Identifier 5: 7004470
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: NC
Other Provider Identifier 6: NCB705A
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: NC
Other Provider Identifier Issuer 6: PALMETTO GBA MEDICARE EFFECTIVE 2/25/2013
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No